Reflective Practice In Nursing



Assignment title: Reflecting on internship placement and emerging competencies.

Aim of assignment: This assignment aims to provide the student with the opportunity to use critical reflection to analyse an experience that contributed to the development of his/her professional nursing competencies.

What are you required to do?

Reflect on one incident that you experienced during your internship practice placement which you consider to be significant.
I am Interniship 4th year Irish student nurse reflecting on incident in practice placement. I will give you a description of the incident below and can base the reflection of each stage of the reflective cycle on the incident I have provided. You will include evidence base throughout the reflection.
Here are some guidelines you must include.
MUST Introduce what you plan to do throughout the assignment so the corrector knows what the assignment will entail. BE VERY CLEAR
• Must critical analyis reflective practice in nursing
• Must use the Gibbs (1988) reflective framework- discuss briefly the gibbs cycle why you are using this framework. I
• Critically Reflect on the incident using each stage of the Gibbs Reflective Cycle
• MUST critically anylase how the experience influenced the development of my professional competency (An Bord Altranais 2005).
• The professional competency I have choosen is Professional Practice/Ethics: DOMAIN 1 in the competence assessment tool for nurses . I will include the attachnment of the competence assessment tool.
• YOU MUST make the reflection flow from each stage ensure to make sure you link each paragraph making clear what you are gong to discuss next.
• Use of the ‘first person’ is appropriate in personal reflections.
• Support your reflection with reference to a comprehensive range of relevant literature.
• The description of the incident must include sufficient detail to enable the reader to understand the student’s experience but should do so in a succinct fashion.
• The assignment must include a detailed and realistic action plan which addresses the issues referred to within the assignment.
• Use Harvard referencing system only
• Must use evidence throughout to support the reflection

• Must include explore literature such as the following: I will include some documents :
• Values In Nursing (Nursing Midwifery Board Of Ireland, 2015)
• Nurses Act 2011
• Patients Experience- How the patients experience in this incident was affected
• MUST refer to me working with Scope of Practice ((Nursing Midwifery Board Of Ireland, 2015)
• Code Of Professional Conduct and Ethics standards and guidance

An Bord Altranais (2005) Requirements and standards for nurse registration and education programmes (3rd ed), Dublin: An Bord Altranais.

During my internship practice placement I was working on a surgical ward, in which I had recently developed my competence in transporting and collecting patients from theatre. On one particular morning, I transported my patient to theatre, and later that morning I returned to theatre to collect my patient after surgery. Upon entering the theatre recovery room my I saw my patient across in the third bay, at a quick glance at the monitor I could see her heart rate was raised, however, before I had even arrived at the bedside the registered nurse had begun to remove the monitoring equipment from the patient without giving me the opportunity to assess the patient’s vital signs. I immediately noticed that patient visually appeared in distress and pale in color. When I asked Patient X how she was felt she replied that she was feeling a ‘lot of pain’ and ”didn’t feel right”. The registered nurse quickly interrupted, telling me’she’s fine hunny’”‘everything is just fine here loveen’. She began to give me a brief handover and when I asked the nurse could I check the patients wound sites she began to sigh and roll her eyes in the air. I persisted to express my concern to the registered nurse on the pain level patient X was experiencing. However, she brushed off my concerns by using the fact that I was “only a student” and she knew best. I then asked the nurse if she could then ring the ward to make them aware that she was happy for me to return to the ward the patient. The registered the nurse then left the recovery room to ring the ward. I noticed just across from the bedside the doctor was sitting the desk. While the registered nurse was not present I plucked up the courage to ask the doctor if he was happy to let the patient to return to ward as she was experiencing high levels of pain. He began to assess the patient at the bedside, the nurse then re-entered the room and he alerted her that they should keep patient X for some further time to monitor her pain level. The nurse confronted the doctor at the beside about questioning her initial decision and abruptly responded to me by telling me that she had already made the decision that the patient fully recovered to return to the ward. I responded by saying I would return a while later when the patient X pain level was under control. I reassured the patient I would be back a short while later, and I left the recovery room Approximately one hour later I returned to recovery room the patient had received strong pain relief and had much improved upon my assessment she ready to return ward setting.

Isolated-student nurse questioning registered nurse years of experience
Knocked my confidence
Emphatic for the patient
Non verbal cues rolling the eyes felt like an inconvience when I asked to see the wound sites

On the contrary, I felt courageous asked the doctor for advice
I felt relieved that the doctor felt the patient should stay in recovery until her pain was under control. I had felt reassured when I returned too the theatre room the second time that patient had received pain relief and pain level was much improved. I felt stronger more confident in my judgment and ability after.

Sample Solution